30例Tg免疫反应的甲状腺髓样癌临床病理及预后分析

Medullary Thyroid Carcinoma wlth Immunoreaction to Thyroglobulin——A Comparative analysis of 30 Cases on Clincopathology and Prognostic Aspects

分析30例MTC,根据对Tg免疫反应有无分成两组:Tg阴性组12例,Tg阳性组18例进行对比观察。发现Tg的免疫表达不仅出现在瘤性滤泡上皮,同样可出现于无滤泡的MTC实质区和转移淋巴结内,与CEA、CT、NSE呈同步的免疫阳性反应。并发现在年龄、瘤体大小、术后5、10年的生存率方面Tg阴性组和Tg阳性组的比较存在明显的差异,显示统计学上的意义(P<0.05)。由此支持MTC中Tg可能来自神经内分泌肿瘤中瘤性干细胞的多方向分化的论点,并提示Tg的表达可能预示较好的预后。

This paper analysed 30 cases of medullary thyroid careinoma(MTC),which were divided into 2 groups: Tg—positive group(18 cases) and Tg—negative group(12 cases). The results showed: 1. the positive immunoreaction to Tg was found not only in the neoplastic follicular epithelial calls, but also in the non—follicle area and metastatic lymph nodes, 2. they reyaled synchronous immune response to Tg as well as to CEA, Calcitonin(CT) and NSE, 3. the 5, 10 years survival rate after operation in positive group were statistical higher than that of negative group. (P<0.05). Therefore, the Tg—expression in MTC may possibly originate from pluripotant stem cells in the neuroendocrine tumors, and it seems to have a better prognosis.